The Pregnancy Risk Assessment Monitoring System (PRAMS) is a CDC/state cooperative project aimed at reducing infant mortality and other adverse birth outcomes in the United States. As part of this effort, Ohio PRAMS is an ongoing population-based survey of women with a recent live birth in Ohio. The survey is conducted via a mailed questionnaire with telephone follow up of mail non-responders. Survey participants are selected randomly from Ohio's vital birth records and contacted within two to four months of the birth of their infant. The PRAMS questionnaire solicits information about maternal behaviors and experiences before, during, and after pregnancy, and during the early infancy of the child. This information is used to assess trends in and associations between outcomes and risk factors statewide. In addition to producing statewide estimates, oversampling among birth mothers in Ohio's three largest counties is carried out to provide similar sub-state information for Ohio's most populous areas. As part of the Ohio Department of Health's mission to protect and improve the health of all Ohioans, the overriding objectives of PRAMS are to provide, on an ongoing basis, information needed to develop Ohio public health programs and policies aimed at reducing adverse pregnancy outcomes, and to assess their effectiveness. Specific aims of the PRAMS project are aligned with the Title V Maternal and Child Health Block Grant mission to ensure the health of all mothers, infants, children, adolescents, and children with special health care needs. For project period 2011-2016, Ohio PRAMS will particularly focus on Ohio's Title V priorities of addressing unintended pregnancy in populations at risk for poor outcomes, low birth weight births among African American women, and indicators of preconception health. By monitoring trends and risk factors in these areas, the intent is to better align Ohio public health program objectives and resources where they may have the greatest impact, and to subsequently monitor that impact.